Extensive listening: What you can do to prevent Alzheimer's

Alzheimer's doesn't have to be your brain's destiny, says neuroscientist and author of Still Alice, Lisa Genova. She shares the latest science investigating the disease — and some promising research on what each of us can do to build an Alzheimer's-resistant brain.

Lisa Genova wields her ability to tell a story and her knowledge of the human brain to talk about medical conditions like Alzheimer’s in warmly human terms.

Her writing, often focusing on those who are misunderstood, explores the lives of people living with neurological diseases and disorders. A bestselling author, her work has been transformed into an Oscar-winning film, Still Alice, but the real triumph is Genova’s ability to help us empathize with a person’s journey we otherwise couldn’t even begin to understand.

Her newest book, Inside the O’Briens, is about Huntington’s disease.

You can read a full transcript here.

Extensive listening: A video game to cope with grief

When Amy Green's young son was diagnosed with a rare brain tumor, she made up a bedtime story for his siblings to teach them about cancer. What resulted was a video game, "That Dragon, Cancer," which takes players on a journey they can't win.

In this beautiful talk about coping with loss, Green brings joy and play to tragedy. "We made a game that's hard to play," she says, "because the hardest moments of our lives change us more than any goal we could ever accomplish."

Amy Green writes and designs video games for Numinous Games, whose first title, That Dragon, Cancer, was an intimate autobiography of the life and death of her son Joel Green. Along with her husband and a team of six other developers, she used a video game to artistically portray the surreal emotional landscape of raising a child with a terminal illness.

You can read the full transcript here.

Does switching on a Satnav switch off part of the brain?

Scientists say using a Satnav can switch off part of the brain, which could have implications for our health.

Self-study activity:
Watch the video and say whether the statements below are true or false.



1 Following the directions of a satnav have deep effects on our brains.
2 Driving around Soho is not difficult.
3 The hippocampus stops working when drivers use a satnav.
4 Seven roads start at Seven Dials in Covent Garden.
5 Taxi drivers in general have the most developed hippocampus.
6 There are around 26,000 places of interest in London.
7 Medical research has proved that underuse of the hippocampus leads to mental diseases.

Some drivers like to follow their nose. Others are more than happy to be told where to go.
After 100 yards, bear left...
More and more people will not leave home without their trusty sat-nav.
It is vital to find places easily.
It is, sort of, I suppose takes the stress out of going somewhere that you don't know.
But what effect does slavishly following directions have on our brains? Neuro scientists at University College London have published research claiming it’s quite profound. Volunteers like Will here were taken around Soho, one of the most complicated road networks in the world. They were then put in an MRI scanner and, using virtual reality, were asked give directions.
So what we did here is look into the human brain, at Will’s brain and many others, to see is there a part of the brain that knows automatically the number of options or the changes in the number of options. But when the volunteers were told the route using a Satnav, scientists noticed the navigational area of the brain, called the hippocampus, stopped working.
You’re no longer engaging those bits of your brain that you would do normally if you were using your memory to sort of pick apart the street network as you navigate. So effectively, the Satnav is turning off the engagement of these brain areas.
Now this is Seven Dials in Covent Garden, and it’s called that for a reason. There are seven different roads converging so I have lots of options here and my brain is currently trying to work out which road to take. But not just that, which road to take after that, and after that, and after that. It’s processing lots of information to try and get me to my destination as quickly and safely as possible. But, this research suggests, if I were to activate my Satnav here, this will do all the decision-making for me. So that part of my brain just switches off.
This research builds on a previous study which found London's black cab drivers have the most developed hippocampus. They have to memorise thousands of roads, routes and landmarks.
It is not in your long term memory, it’s in your short term memory.
Then the brain very quickly becomes a sponge once again and it clicks on to this road leads to this road that leads to that road, I can’t do that road because it’s one way. And in over a series… an amount of time, it grows and grows and grows. So that said, you know, it’s extremely difficult, not just because you’ve got to know 26,000 roads, and thousands and thousands of places of interest, but it’s… we are remembering how to remember them again.
The research team wants to build on the study to explore the wider medical implications, whether underuse of the hippocampus, for example, contributes to the onset of Alzheimer and dementia. But for the first time, there is firm evidence that switching this on switches off an important part of our brain.
Marc Ashdown, BBC London news.

KEY:
1T 
2F 
3T 
4F (converge) 
5F (London's black cab drivers) 
6F (26,000 roads) 
7F (it’s just a hypothesis)

Survey finds millions of Americans working on too little sleep

Daylight saving time starts in late March. The clocks spring ahead an hour, which means many will fall behind on their sleep. But being sleep-deprived is nothing new for many Americans.

Self-study activity:
Watch the video and answer the questions below.



1. How much sleep does John Hanford get a weeknight if he’s lucky?
2. And if he’s unlucky?
3. How does the woman being interview do to keep awake during the day?
4. What is the percentage of people who dream about their work?
5. How many of them often dream about work?
6. What might happen if one gets worried about not sleeping?

Daylight saving time starts this weekend. The clocks spring ahead an hour, which means many will fall behind on their sleep. But as Hena Daniels reports, being sleep-deprived is nothing new for many Americans.

John Hanford heads to work most days feeling a little tired.
How much sleep do you get on a weeknight?
I would say I get six hours a night if I’m lucky.
When you’re not lucky?
Four, sometimes even three.
Adults are supposed to get eight hours of sleep each night, but a new CareerBuilder survey finds only one-in-five workers actually reaches that goal. That means millions are working on too little sleep, and most say it has an impact on their job.
I mean, it’s definitely harder to concentrate when you feel tired or you’re constantly having coffee to stay awake.
In the survey, people say being tired makes them less productive and less motivated. It also affects their memory and makes them crabby.
Many people can’t escape work, even when they’re sleeping. 65% of people say they dream about work. One-in-ten say it happens often.
I’ll have nightmares that I forgot a deadline, or I have something that was due.
So, it’s a struggle.
Kevin Judge says being tired makes the day move slower.
You feel like the whole day is going by and you just, you can’t wait to get to sleep that night.
But worrying you’re not getting enough sleep can make things worse.
You get stressed about not sleeping and then it makes it harder to fall asleep.
Ironically, half of those surveyed said thinking about work keeps them up at night.
Hena Daniels, CBS News, New York.

KEY:
1 six hours
2 three or four
3 she’s constantly having coffee
4 65%
5 One in ten
6 They may find it harder to fall asleep.

Extensive listening: The ethical dilemma of designer babies

Creating genetically modified people is no longer a science fiction fantasy; it's a likely future scenario.

Biologist Paul Knoepfler estimates that within fifteen years, scientists could use the gene editing technology CRISPR to make certain "upgrades" to human embryos — from altering physical appearances to eliminating the risk of auto-immune diseases.

In this thought-provoking talk, Knoepfler readies us for the coming designer baby revolution and its very personal, and unforeseeable, consequences.

Dr. Paul Knoepfler is working to figure out how we use safely stem cells to treat many diseases and how they sometimes turn to the dark side to cause cancer. Over the years he has made key discoveries about how stem cells and cancer are programmed. Now he is especially interested in how to hack these cells to control their behavior, including using powerful CRISPR genetic modification technology.

Knoepfler has also been a leading voice in the discussion about how CRISPR could be used to make designer babies and the risks of going down that path. He is a professor of cell biology and anatomy at UC Davis School of Medicine in California, where he both does research and teaches. In addition, he is a prolific writer including his popular science blog, The Niche, and two books: Stem Cells: An Insider's Guide and GMO Sapiens: The Life-Changing Science of Designer Babies. He is excited about contributing to efforts to build an innovative, global community of interconnected people with a shared passion for biomedical science and battling fake science. Knoepfler’s outspoken, approachable nature in tackling some of the most transformative questions in science has made him a go-to scientist for journalists and ordinary people across the globe.

You can read the full transcript here.

Reading test: Happiness depends on health and friends, not money, says new study

For this week's reading test we are going to use The Guardian article Happiness depends on health and friends, not money, says new study, by by Phillip Inman.

Read the article and choose the option A, B or C which best completes each sentence.

Happiness depends on health and friends, not money, says new study

Most human misery can be blamed on failed relationships and physical and mental illness rather than money problems and poverty, according to a landmark study by a team of researchers at the London School of Economics (LSE).

Eliminating depression and anxiety would reduce misery by 20% compared to just 5% if policymakers focused on eliminating poverty, the report found.

Lord Richard Layard, who led the report, said on average people have become no happier in the last 50 years, despite average incomes more than doubling.

The economist and former adviser to Tony Blair and Gordon Brown said the study, called Origins of Happiness, showed that measuring people’s satisfaction with their lives should be a priority for every government. The researchers analysed data from four countries including the US and Germany.

Extra spending on reducing mental illness would be self-financing, the researchers added, because it would be recovered by the government through higher employment and increased tax receipts together with a reduction in NHS costs from fewer GP visits and hospital A&E admissions.

“Tackling depression and anxiety would be four times as effective as tackling poverty. It would also pay for itself,” he said. The report supports the arguments put forward by Layard over several decades that social and psychological factors are more important to the wellbeing of individuals than income levels. “Having a partner is as good for you as being made unemployed is bad for you,” he said. The report claims that state-run organisations, including schools, must become more focused on tackling anxiety and mental health issues.

“This evidence demands a new role for the state – not ‘wealth creation’ but ‘wellbeing creation’,” Layard said. “In the past, the state has successively taken on poverty, unemployment, education and physical health. But equally important now are domestic violence, alcoholism, depression and anxiety conditions, alienated youth, exam mania and much else. These should become centre stage.”

The economist said it was a curse on children that they were judged by society solely on their educational attainment. The report adds: “The strongest factor predicting a happy adult life is not children’s qualifications but their emotional health. There is also powerful evidence that schools have a big impact on children’s emotional health, and which school a child goes to will affect their emotional wellbeing as much as it affects their exam performance.”

Layard rejected accusations that he was arguing against closing income inequalities but said improvements in mental health services would have a greater impact.

The health secretary, Jeremy Hunt, has pledged to increase funding for mental health services. In September he said the care offered to children and young people was the service’s biggest weakness.

But the Department of Health admitted last month that the number of mental health nurses working in the NHS in England has dropped by almost a sixth since the Conservatives came to power in 2010, from 45,384 in England to 38,774 in July this year.

The report will be presented to a conference in London on Monday that has been organised by the LSE and the Organisation for Economic Co-operation and Development.

1 According to a team of researchers at the London School of Economics
A. eliminating depression and anxiety would make people four times happier.
B. failed relationships is at the root of human unhappiness.
C. money problems don’t bring unhappiness.

2 In the last 50 years
A. our income has stayed the same.
B. our level of happiness has not changed.
C. people have become poorer.

3 In Lord Richard Layard’s opinion, the money spent on reducing mental illness
A. might bring more unemployment.
B. would lead to an increase in taxes.
C. would pay for itself in the long run.

4 The study Origins of Happiness claims that
A. citizens’ mental condition should be prioritized.
B. income levels are not really important to citizens.
C. it is convenient for people to have a partner.

5 The study says that so far the state has failed to deal with
A. domestic violence, alcoholism, depression and anxiety conditions, alienated youth, exam mania.
B. poverty, unemployment, education and physical health.
C. both A and B.

6 The study also emphasizes that
A. exam results should be given priority.
B. exam results should not be a key factor in a child’s development.
C. the choice of school is of no importance for a child’s development.

7 At the end of the article it is said that
A. income inequalities are not being taken into consideration anymore.
B. the money spent on mental health services has been increased.
C. there has been a reduction in the mental health staff.

Photo: Perth Now

KEY: 
1B 2B 3C 4A 5A 6B 7C

Listening test: My secret to long life

Listen to a report on Emma Morano, who is the oldest person in the world. Complete the blanks in the sentences with up to THREE WORDS. 0 is an example.

Source: Deep English

0 Example:
Emma Morano was born in November 1899.

1. She is ____________________ years old.

2. As a teenager, her doctor recommended raw eggs to protect her ______________________ .

3. She has eaten over ______________________ eggs in her life.

4. Another secret of Emma’s longevity is ______________________ .

5. At the time of her separation divorce ______________________ .

6. Emma has never been lonely. On the contrary, she has many ______________________ .

7. For her birthday Emma received ______________________ from people all over Italy.

8. The idea that a person needs a romantic relationship to be happy comes from ______________________ , but it might not be for everyone.

Italian Emma Morano is the oldest person in the world. Born in November of 1899, she is the only living person to have lived in the 19th, 20th and 21st centuries. At 117 years young, she is in great health and has a sharp mind. Her doctor says, “She’s in great form.”
Emma eats a diet of eggs, bananas, and cookies. When she was just a teenager, her doctor recommended raw eggs to protect against anemia, and she has stuck to it religiously. Until recently, she ate three raw eggs a day, which totals more than 100,000 over a lifetime. She has recently cut down to just two raw eggs, but she still believes they are what have kept her going all these years.
In addition to raw eggs, her other secret to a long life is staying single. In 1938, she separated from her husband after the death of her child. It was an unhappy marriage, but Emma bravely decided to go her own way at a time when separation was rare and divorce wasn’t even legal. She had many suitors over the years but rebuffed them all preferring to stay single. She said, “I didn’t want to be dominated by anyone.”
This is not to say she has lived the life of a loner. In fact, she has many deep relationships. Her doctor pins her longevity on these relationships over the eggs and staying single. He says, “The secret is in growing old with people who love you, which is different from growing old and being put up with.” Indeed, Emma was surrounded by loved ones at her birthday and received well wishes from people all over Italy.
Emma Morano’s longevity might have nothing to do with eggs or staying single, but she certainly thinks it does. And this belief flies in the face of everything that most people believe. Tropes like needing a romantic partner to complete us are all around us in popular culture. But perhaps not everyone is meant to be with someone. And maybe the key to a long and happy life has nothing to do with finding a life partner.

Key:
1 117
2 against anaemia
3 100,00
4 staying single
5 was illegal / wasn’t (even) legal
6 deep relationships
7 well wishes
8 popular culture

Talking point: Medication

This week's talking point is medication. Before getting together with the members of your conversation group, go over the questions below so that ideas come to mind more easily the day you get together with your friends and you can work out vocabulary problems beforehand.

What do you think the photo shows?
Do you think it shows a positive or a negative  view of health and medicine?
What kinds of things do you think pills might be good for?
What different kinds of medication can you buy in a chemist's without a prescription?
How are these conditions usually treated?

a broken bone - a rash - a sprain - a nasty cut - flu - an allergy

How often do you go to the doctor?
When did you last go? Why?
What was the treatment?
How often does the doctor prescribe medicines when you visit him/her?
How much money does your household spend on medicines every month?
Where do you keep them at home?
What medicines do you take with you when you travel?
Do you know anyone who is in the habit of taking too much medication?
Do you know anyone who refuses to take medicines and would rather have an alternative treatment?
Do you know any doctors who are reluctant to prescribe drugs?

Dealing with a parent with dementia

Reporter Louis Theroux drops in at a traumatic time for new residents and their families at the Beatitudes Senior Living Campus, in Arizona.

Self-study activity:
Watch the video and anwer the questions belowl




1. What problem is Janet Cottrell having?
2. How long has she been staying at Beatitudes?
3. Why did the family take the decision to send her to the retirement centre?
4. Does Janet know that she's going to stay at Beatitudes for ever?
5. What do the staff tell residents at Beautitudes all day long?


My journey began here, at Beatitudes, a retirement community with a specialist unit for people with dementia.
I don't know where she is, if she's OK.
A resident on the second floor, called Janet Cottrell, had seen an intruder.
Janet, who was yelling at you?
The woman that was in here. She was climbing in her pyjamas and going... She was in that room.  I don't know where she could have gone so fast.
Well, if you see her again, let her know, or you can push your button.
Dawn Grant is in charge of the unit.
Do you think that was a hallucination?
I do believe so.
Why could it not be a real person?
I don't have any other small females, skinny, running round in their jammies right now.  Another resident. And they can't move that fast, either.  So it's probably a hallucination. Well, it is a hallucination.
Janet was a new arrival at Beatitudes.  Her daughter, Nancy, came to see how she was settling in.
Do you like the chair, Mom?
Pardon?
Do you like the chair?
Do I like the chair? Yes, very much so.
So your mum just moved in yesterday, is that right?
Yes.
And how did that go?
It was pretty emotional. In the morning it was very, very difficult  when we told her she was coming.
How did you get to the point of feeling she needed to be here?
She walked away from the house one day, and she didn't know where she was, and nobody knew where she was,  so that was the end of my being able to take care of her,  because I couldn't keep her safe anymore.
Course, I keep thinking, you know, she likes to go out a lot, but we aren't allowed to go out. We don't have a car.
Once your car was taken away, was that quite a big thing for you?
It was terrible, and it still is. And Nancy says I cannot get my car back.
My mom, I hope, knows that I love her very much, and that the reason that I'm doing these things is to keep her safe, and I hope she remembers that.
See, if you just leave me alone, I do all good things by myself.
Yeah.
At any point did you kind of say to Janet, ‘This is basically where you'll be living now’?
Not yesterday before we left, no.  It wasn’t until… And we really actually haven't said that, I've not said that to her at all.
Do not talk about her as though she's not in the room.
OK.
Include her in, or don't have a conversation in front of her.
Yeah.
She's not saying, ‘When can I go home?’, or anything?
She's not, but she is under the impression she's here temporarily.
She is, but so is Sonja, her roommate.
Right, and half of the people here.
Yeah, they all think they're going.
They do?
It's just such a transition to take them from what they're so used to, to putting them in a new setting.
It's OK to tell...I guess they'd be white lies, is that the right term?
Yes. We do it all the time.
Yeah, we tell white lies all day long here, all day.

Key:
1 She says she's seen an intruder
2 Just one day 
3 They can't look after her. One day she walked away from the house and she didn't know where she was.
4 No, they haven't told her yet. 
5 (White) lies

Tonga's obesity crisis

The Pacific island of Tonga is the most obese country in the world. Up to 40% of the population is thought to have type 2 diabetes and life expectancy is falling.

Self-study activity:
Watch the video and answer the questions below.



1 How has the diet of Tongans changed in recent years?
2 What does 90% refer to?
3 What happened to Kesaia as a result of the complications of her diabetes?
4 How do some scientists explain the obesity problem?
5 Why do food and eating play an important role in Tonga?
6 What solution to the problem is Tonga's Health Minister thinking of?

Every morning Tonga's fishermen bring their catch to the local market but it is getting harder to sell to customers, especially when there is competition like this: On the other side of the harbour, cuts of imported meat such as these fatty mutton flaps have become a Tongan staple in recent years. With globalisation trade has become easier and food cheaper, supermarkets are stocked with tinned and frozen meat from abroad and local produce is relatively costly.
It’s the foreign food that is being blamed for our health crisis here and across the Pacific Islands. It’s a crisis that isn’t just costly for health but for the government's finances too.
This is the queue for the daily diabetes clinic, the biggest queue by far here in the country's main hospital. 90% of Tongans are obese or overweight and it has a massive health impact. This country has one of the highest levels of type two diabetes in the world.
The doctors are working flat out. Despite government initiatives to make people aware of the dangers of obesity and illnesses like diabetes it is yet to make a big difference here.
Where we are, we still continue to see so many people living with diabetes. Our workload is not easing up. If anything, it’s expanding.
The Huni family have been through a lot. Kesaia lost her leg several years ago because of complications with diabetes, but she is not the only one suffering.
It started with my grandma, now my mum, my dad, two of my sisters and now me, and we’ve gone from, you know, just eating whatever to watching what we eat.
Some scientists believe Tonga's problem is partly down to genetics, that Pacific Islanders in the past had to survive long periods without food, so their bodies are programmed to cling on to fats. But diet plays a huge role and in a deeply religious country where feasting and food are central to life here, it’s a hard message to sell. Even Tonga's health Minister thinks people could do more to help themselves. Charging for health care may be unpopular, but he thinks it could make a difference.
They know that if they do this, they will get sick and they will end up in the hospital, and if they end up in the hospital they will have to pay. But right now that is not the mentality of people, we do what we do to get sick, we won't be charged. 

Key:
1 They have stopped eating fish and started to eat meat.
2 Percentage of Tongans who are obese or overweight. 
3 She lost her leg. 
4 It has to do with genetics.
5 Because of religious reasons.
6 Making people pay for health expenses.

Listening test: The risks of office work

Listen to part of a BBC radio programme where Professor Ulf Ekelund, from the Norwegian School of Sports Sciences,  answers questions on the risks of office work and choose the option A, B or C which best completes each of the sentences below.



1 Sitting at a desk for eight hours
A demands the same physical activity as an hour’s walk.
B is harmful for a person’s health.
C leads to premature death.

2 Professor Ulf Ekelund thinks the really harmful thing for a person’s health is
A lack of activity.
B office work.
C smoking.

3 Standing from a desk
A is a form of physical activity.
B is not a form of physical activity.
C has not been demonstrated that it is physical activity.

4 Workers who spend their day sitting at a desk
A must cycle or go out for a walk for an hour every day.
B should drink more coffee.
C should try and do physical activity in the workplace.

5 Increasing physical activity by 10 to 20 minutes would
A diminish the risk of chronic diseases.
B motivate the population to live a healthier life.
C put an end to premature death.

6 Professor Ulf Ekelund says
A five million people die because of lack of activity every year.
B five million people die because of smoking every year.
C the research on the effects of inactivity started 4 years ago.

7 The research
A hasn’t reached conclusive results.
B monitored 1 million people.
C monitored 13 million people.

It’s crazy to smoke, we all know that because it’s so bad for your health, but going to work and sitting at a desk? The Telegraph’s headline this morning is: Working in an office - as bad as smoking. They’ve picked up on a study published in The Lancet, it’s of a million people and it suggests that if you sit at a desk for eight hours a day then you increase your risk of premature death by 60%, but if you’re active for one hour, even just going for a walk, then you undo that damage. Well the man leading the research was Professor Ulf Ekelund from the Norwegian School of Sports Sciences and he’s here in the studio. Good morning.
Good morning.
Let’s start with that headline, is it true that sitting at a desk for eight hours is as bad as smoking?
Well, I would say physical inactivity is as bad as smoking, so if you compare smokers with non-smokers and if you theoretically could take all smokers to be non-smokers and you could take all of those of us who are inactive to become active then the risks are more or less the same.
OK, I think I’m following you there. And you particularly, well there’s a number of things you pick up there but one, it’s the inactivity, so it’s being written up as going to work for eight hours, but if you were sitting on your sofa for eight hours it’s obviously the same thing?
Yes. Now, I mean, what we found in our research was basically that if you are physically active for an hour a day, at least an hour a day, such as walking or bicycling you could offset the risk of prolonged sitting, or sitting for more than eight hours. That was the main finding of our study.
OK, there are also fashions at the moment for people to raise their desks and stand, does that undo some of the problems?
I don’t think there is much evidence for that. I think there is strong evidence that you should break up your sitting time by doing activity. I mean, I think it’s actually okay to just take a short walk to go and get some coffee at the coffee machine or something similar, but just standing up may not be associated with any improved health.
OK, so you’re not necessarily talking about head out for an hour, brisk fast walk or a cycle, you can break up this hour by lots of walks to the kitchen?
You can do that, but I would also recommend trying to engineer physical activity into your everyday life and using the stairs rather than the escalators or the lift.
So there are, and that will make a huge difference from the sounds of this?
It will make a difference. I mean, we know that on the population level if we could increase physical activity by 10 to 20 minutes we would have a very much reduced risk of many chronic diseases and also premature mortality.
I thought you were going to say that you couldn’t compare it to smoking, but the idea that they are comparable is extraordinary, isn’t it, because one you’re obviously taking in carcinogens, pollutants, a whole series of bad things, the other you’re just sitting?
Yes, but I mean the number of deaths attributable to physical inactivity which we published in the first Lancet series four years ago is more than five million people globally, and that is very comparable to the number of deaths from smoking.
So all it takes is a bit of activity and that will make the significant difference, and we should talk about the scale of course, it’s a million people you looked at here, so it’s a…
That’s true, we summarised data from 13 studies including a million people, and I think the public health message is sit less, move more, and the more the better.

KEY:
1B 2A 3C 4C 5A 6A 7B

Listening test: Breastfeeding expert defends nursing two-year-olds

Listen to this radio news item on breastfeeding and choose the option A, B or C which best completes each sentence. 0 is an example.

source: Radio Sweden

0 Example:
The child
A is five years old.
B is two years old.
C was never breastfed.

1 The mother was accused of
A abusing breastfeeding.
B abusing her daughter.
C not paying enough attention to her daughter’s health.

2 According to expert Sofia Zwedberg,
A breastmilk doesn’t contain all nutrients that a child needs.
B babies should be exclusively fed with breastmilk until six months old.
C babies should always receive additional iron and vitamin C while being breastfed.

3 The problem with the child is
A she has shown signs of malnourishment.
B she’s small for her age.
C she wasn’t breastfed as a baby.

4 In Zwedberg’s opinion
A breastfeeding being bad for older children is a myth.
B breastfeeding sometimes leads to maltreatment.
C mothers can force a child to breastfeed.

5 The mother
A admits being careless with her daughter’s health.
B has been reported to social services.
C has had mental problems as a result of the controversy.

6 The mother
A has admitted that her child is often ill.
B says the importance of breastfeeding goes beyond food.
C was given advice on how to feed her daughter.

7 Expert Sofia Zwedberg says
A a hundred years ago children were breastfed until the age of 5.
B children enjoy breastfeeding.
C the breastfeeding experience is similar in all mothers.

A Swedish mother faced being reported to social services for breastfeeding her two-year-old, but one expert says children should ideally be breastfed up to age five.
Earlier this year, the mother was told by a nurse at a child health care centre in Luleå, in northern Sweden that her daughter was not growing fast enough and that unless the she stopped breastfeeding her, she would be reported to social services. The mother was told that breastfeeding her two-year-old was tantamount to child abuse and that it was hampering the child’s growth, local newspaper Norrländska Socialdemokraten reported earlier this month.
But other breastfeeding experts disagree. Speaking to Swedish Radio, Sofia Zwedberg, a midwife and a breastfeeding researcher at the Karolinska Institute in Stockholm, said she would prefer to see more mothers breastfeeding their two-year-olds.
Zwedberg said breastmilk contains all nutrients that a child needs and that the global recommendation is for mothers to breastfeed exclusively for six months and then to combine breastfeeding with other feeding for two years or more to ensure the child receives enough iron and vitamin C.
According to the mother in northern Sweden, at two months her child was small and below the growth chart that shows the standard ranges for height and weight. Her daughter had apparently been fully breastfed for six months and after that partially breastfed, but she wasn’t eating enough food. But the mother said that the girl showed no signs of malnourishment, nutrient shortage or iron deficiency.
Zwedberg, breastfeeding expert at Karolinska Institute, told Swedish Radio that the idea that it is terrible to breastfeed older children is a “social construct”. Zwedberg said a mother can never force a child to breastfeed and so it is not a question of maltreatment.
And speaking to the newspaper Dagens Nyheter, the mother in Northern Sweden said she was distressed after being told that she needed to stop breastfeeding completely or risk being reported to social services. She said “I had a breakdown. Would I, who had always done what I thought was best for my child, be reported for child abuse?”
The mother herself reported the child health care centre in Lulea to the Health and Social Care Inspectorate, stating that she did not receive any other advice apart from the order to stop breastfeeding. She told Dagens Nyheter that for her and her child, breastfeeding “was about much more than just food”. She said it was a way for my daughter to fall asleep, to feel closeness or just to cuddle in the morning.” And she added “breastfeeding was also a saviour when she was ill and had a fever and neither ate nor drank”.
Sofia Zwedberg, at the Karolinska Institute, said women have different experiences breastfeeding and that each case has to be treated individually. However, she said that “biologically speaking, we are meant to breastfeed up to age five but, she insisted, our lifestyles mean that women today choose to stop breastfeeding early.” “If it were up to the children,” said Zwedberg, “we might see more older kids breastfeeding.”

KEY:
1A 2B 3B 4A 5C 6B 7B

The doctor who saved 100,000 eyes

Nicholas Kristof travels to Nepal to meet an ophthalmologist who may have cured more people of blindness than anyone in history.

Self-study activity:
Watch the video and answer the questions below.



1 How many peoplas has Sanduk Ruit personally cured?
2 How long does the eye surgery festival last?
3 How many peoples does the Himalayan Cataract Project operate on in that time?
4 When will the patient see well again after the operation?
5 How much does each eye surgery cost in Nepal?
6 What is Dr Ruit helping do?

Tully Maia is blind. Without her vision, she can no longer farm, and her family risks going hungry. For centuries the only option for people like Tully Maia was to accept a life of blindness. But now, somebody is changing that.
I’m Nicholas Kristoff. I’ve come here to Nepal, a country still struggling from this year’s earthquake to visit a public health legend.
Dr Ruit…
Thanks for coming!
Such a pleasure to see you!
Dr Sanduk Ruit may have restored sight to more people than anyone else in history.
We claim that the vision outcome is as good as anywhere any the world.
Wow!
He’s bringing inexpensive eye surgery to poor people with cataract blindness, and not just a few. He has personally cured more than 100,000 Nepalese and counting.
People have come from around the region, some of them trekking all day to attend the eye surgery festival put on by Dr Ruit and his organisation, the Himalayan Cataract Project. Over just two days, Dr Ruit and his team operate on more than a hundred people. It’s an assembly line of hope.
Dr Ruit we brought you a patient. This is Tully Maia.
Tully Maia.
So what are you doing now?
You know, Nick, I am opening the gateway to the eye. There’s a membrane that I’m opening. There are not many medical interventions where the investment is so strict and the return is so straight. I know the patient is going to see very well tomorrow. I’ll get you to have a look at the nucleus.
Wow! That is the cataract that was making her blind.
Cataracts cause half of all blindness worldwide. In places like American removing them is no big deal. In fact, my mother just had the surgery this summer, but the standard operation is much too expensive for places like Nepal. So Dr Sanduk Ruit created a grassroots network that screens villages for cataracts, then gathers them together for surgery all at once. His biggest innovation was simplifying that surgery so it costs just $25 per eye.
That’s it a few minutes per eye and you’re done.
Assistance like this would have never been developed in the West, where it’s just not necessary. And now that it’s proven in Nepal, Dr Ruit is helping bringing it to Africa, meaning a heroic doctor who’s already cured hundreds of thousands may soon be responsible for curing millions more, allowing them to see again, work again and get their lives back.
Twenty-four hours later, it’s the moment of truth.
How many fingers am I holding up?
Three.
You can go.
Very good.

Key:
1 more than 100,000
2 two 
3 more than 100
4 the following day
5 $25 per eye
6 developing the same scheme in Africa

A cure for diabetes in India?

Could a simple change in the diet of expectant mothers prevent their children from developing diabetes?

Self-study activity:
Watch the video and answer the questions below.



1 What are the two arguments Professor Fall gives against making middle-aged people lose weight to prevent diabetes?
2 Where does Professor Fall's plan to prevent diabetes rely on?
3 What chemical element is important to bone growth?
4 How many snacks are made in the kitchen every day?
5 How many women have participated in the project?
6 Why is it important that the women come to the centre and have the supplement there?
7 As well as having their mental development tested, what other elements of a baby's growth are measured and recorded?
8 Despite the improvement in mothers' diet, which potential problem are the scientists coming across?

Inspired by David's ideas, his colleague, Professor Caroline Fall, is leading a study with the potential to fix the diabetes epidemic in India.
At the moment, if you talk about preventing diabetes, people are talking about making middle-aged people lose weight, and A, that's impossible to do, and B, it doesn't seem to work very well anyway. And so the idea that you could build a human being that was more resistant to this disease was amazing to me.
Caroline's plan to halt the diabetes epidemic doesn't rely on high-tech labs or fancy science. It rests mainly on these women and one kitchen. These recipes contain all the crucial building blocks needed to build a body resistant to disease.
Folic acid, calcium, iron, vitamin A. The calcium will be important for bone growth. The green leafy vegetables contain small quantities of essential fatty acids which are important for brain growth. All of those nutrients are important in different tissues of the body. The foetus, at a very, very early microscopic stage, is sensitive to the nutrients around it and if we miss that, we feel that we would be missing the most important stage of development.
Every day, over 1,500 snacks are made in this kitchen. There are nutrient-rich recipes and others that are green vegetable-free to act as scientific controls. They are taken to about 50 clinics in the slums across the city. In total, over 6,700 women have participated and each must begin eating the supplements well before they fall pregnant. It's a logistical nightmare where the utmost care must be taken to be scientific.
I'm very glad to have met Meera. It's been hard work, it's been hard work setting up a study like this. To carry it out on the ground in a population like this is very difficult.
It's mandatory for a woman to come to the centre and have the supplement in front of the project clerk because it is very important, you know, because if they take it home, somebody else can eat it. They can throw it out or the child can eat it. We are not sure who the supplement has gone into, whose stomach, so it's very important to have women coming to the centre.
The centre is full of women eating supplements from well before pregnancy until they give birth. And there are also babies who must be measured at one, three, six and 12 months. Their weight, length and body fat are recorded, and they are even testing their mental development. It is an ambitious long-term project.
For seven-and-a-half years.
How many more?
Forever, I think.
So nice!
The results of this study will begin to come in next year.
We're providing better nutrition into the mother, but the mother herself has had a poor early development, which may affect the quality of her eggs. It certainly affects the size of her uterus and the quality of the blood supply to the uterus. So she is still constraining the development and growth of that foetus.

Key:
1 a) that's impossible to do; b) it doesn 't seem to work very well
2 the kitchen or cooking or diet or recipes
3 calcium
4 1,500
5 6,700
6 to make sure that they actually have it 
7 weight, length and body fat
8 mothers themselves had a poor early development, which may affect the quality of their eggs

Listening test: Sugar tax

Listen to a report on the British government's plans to set a tax on sugary drinks and complete the blanks in the sentences below with up to THREE WORDS. 0 is an example.

source: Gerry's News Digest

0 Example:
UK citizens are expected to pay a tax on sugary drinks in two years' time.

1 The Chancellor of the Exchequer announced the government's plans in the latest government _______________________ .

2 The tax will be imposed on what is UK's biggest single source of excess sugar: _______________________ .

3 The tax will be imposed on the volume of sugary drinks that a company _______________________ .

4 Both milk-based drinks as well as _______________________ will not be taxed.

5 The money collected will be used to _______________________ in schools.

6 The effect the tax has had in some other countries has been positive, at least in the _______________________ .

In two years the UK is going to have a new tax on sugary drinks. I’ve talked before about the latest thinking on the links between sugar consumption and medical problems such as obesity, Type 2 diabetes and so on. In the latest government budget statement, the Chancellor of the Exchequer announced that he’s responding to demands from the health sector to do something about reducing our sugar consumption by imposing a tax on what is our biggest single source of excess sugar: high sugar drinks, which are particularly popular with children and teenagers. The drinks that’ll be affected are things like classic Coke and Pepsi, energy drinks, Fanta and tonic water. The tax will not be on the product as such but on the company. The tax will be on the volume of sugary drinks that a company produces or imports. The tax will be in two bands: one for drinks with more than 5g of sugar per 100 millilitres, and the second band for drinks with more than 8g. The price of a can of Coca-Cola will rise by about 10%. Milk-based drinks as well as pure fruit juices will not be taxed. The drinks industry has two years to get ready, and I’m sure they’ll be lobbying until the last moment against the tax. A feature of the tax will be that the money raised will be kept separate from general taxation and it’ll be used specifically to promote sport in primary schools.
So will the tax have its intended effect of reducing national sugar consumption? Other countries that have already tried something similar include Mexico and Hungary where the short-term result at least has been positive. The debate goes on, however, about the morality of the government trying to control what we consume. 

KEY:
1 budget statement
2 high sugar drinks
3 produces or imports
4 pure fruit juices
5 promote sport
6 short term

Extensive listening -The truth about alcohol

A&E doctor Javid Abdelmoneim is on a mission to find out the truth about alcohol.

In January, the government released its new alcohol guidelines. For men, the recommended weekly limit was cut by a third to 14 units per week, equivalent to about seven pints of beer, bringing it in line with the amount recommended for women. So what is behind the change?

This is just one question of many that Javid aims to answer as he explores the science of drinking and the new evidence for the health risks of alcohol. Why do some people get drunk quicker than others? What is behind red wine's healthy reputation? Is a nightcap actually good for your sleep? Does lining your stomach work? And can alcohol actually make you eat more?

Talking point: Medical science and other health issues

This week's talking point is medical science and controversial health issues. Before getting together with the members of your conversation group, go over the questions below so that ideas come to mind more easily the day you get together with your friends and you can work out vocabulary problems beforehand.

Health issues

• Do you think it should be obligatory for parents to vaccinate their children?
• Is it ever right to switch off the life support of a patient in a vegetative state? Why? Why not?
• Should hospitals be allowed to presume consent for organ donation unless objection has been registered?
• Should smoking be made illegal everywhere, including inside people’s homes, in cars and outside?
• Should smokers pay the full cost of their medical treatment?
• What are the arguments for and against free healthcare for everyone?
• Will imposing a sugar tax help curb obesity?
• Should marijuana be a medical option?
• Do you think alternative medicine (acupuncture, acupressure, chiropractic, homeopathy, hypnosis, hypnotheraphy, herbalism, osteopathy, reflexology) is fraud?
• What are the advantages and disadvantages of genetic engineering (designer babies, cloning human beings)?

Medical advances
Rank these medical advances from the most important (1) to the least important (9). Give reasons.

• Completion of the sequencing of the human genome project
• Stem cell research which may lead to cure diseases and repair damaged tissues
• Targeted cancer therapies to interfere with the spread of cancer
• Laparoscopic surgery (minimally invasive surgery)
• HPV vaccine to protect against cervical cancer and genital warts
• HIV cocktails
• Face transplants
• Bionic limbs
• Nanomedicine

Listening test: Life without wireless

Listen to a man talking about how it is possible to live without technology in US today and complete the blanks in the sentences below with up to THREE words. 0 is an example.

source: Deep English

0 Example:
In today’s technology-saturated world, it’s hard to imagine living life without a wireless connection.

1 The Quiet Zone in Green Bank is a ____________________ mile area that protects two telescopes from any signal interference.

2 Restrictions mean that not even ____________________ in this area.

3 People who suffer from electromagnetic hypersensitivity experience headaches, nausea, ____________________ problems.

4 Diane Schou started experiencing the first symptoms of the disease when a new ____________________ was installed near her home.

5 She started looking for a place in US where she could escape ____________________ .

6 Diane didn’t find it easy to adjust to Green Bank and suffered ____________________ at the beginning.

7 It is difficult to imagine how long we could survive ____________________  of modern technology.

Invisible rays are all around us, and most of us never even notice. In today’s technology-saturated world, it’s hard to imagine living life without a wireless connection. But in one American town, wireless is actually illegal. Green Bank, West Virginia is a small town located in the United States’ National Radio Quiet Zone. The Quiet Zone is a 13,000 square mile area that protects two telescopes from any radio or wireless signal interference. That means no Wi-Fi, no cell phones, no Bluetooth, no microwave ovens, no TV, and even no radio is allowed in this area.
While many of us would shudder at the thought of pulling the plug on our cell phones, laptops, and televisions, the wireless ban has attracted people who suffer from electromagnetic hypersensitivity. Many of these people have decided to live in the town to get relief from their condition, which causes severe headaches, nausea, pain and heart problems.
Diane Schou is one of these people with electromagnetic hypersensitivity. In 2003, after a new cell-phone tower was installed near her home in Iowa, Diane began to experience an onslaught of negative symptoms. First came heart palpitations, then fatigue, nausea and migraines. After learning about electromagnetic hypersensitivity, Schou set off on a journey across the United States, looking for a place where she could escape wireless signals. When a park ranger told her about Green Bank, Schou went out on a limb and moved to the town, and she hasn’t looked back. In Green Bank, she says, she can finally live a life free of pain.
Living in Green Bank is no easy feat, Schou says. Coming to the town is a culture shock, and adjusting to a world with little technology beyond electric lights and heating is hard for many. But for people suffering from electromagnetic sensitivity, it is one of the only places where they can find relief. Today, the town has become a gathering place for a few dozen electrosensitives from around the United States.
While most of us couldn’t imagine life in Green Bank, for the electrosensitives who live there, it’s hard to imagine life outside of it. How long could you survive without all of the conveniences of modern technology.

Key:
1 13,000 square
2 radios are allowed
3 pain and heart
4 cell-phone tower
5 wireless signals
6 (a) culture shock
7 without the conveniences

Are vegetarians healthier or should I eat meat?

Michael Mosley compares the difference between a meat lunch and a vegetarian lunch to find out whether or not it is actually healthier to be a vegetarian?

Self-study activity:
Watch the video and answer the questions below.



1 What percentage of Adventists are vegetarian and what meat-eaters?
2 What is the advantage of using Adventists for health-related studies?
3 How many subjects have participated in Dr Gary Fraser's studies?
4 What's the difference in dietary habits between the reporter and Dr Fraser?
5 What do cardiovascular risk factors involve?
6 How much beef do you need to eat to have massive risk to your health?
7 What's the difference in life expentancy between meat-eaters and vegetarians?

What makes Adventists of particular interest to scientists is that although about half are vegetarian, around half eat meat so the two groups can be compared. And unlike the wider population, Adventist meat-eaters tend not to be heavy smokers or drinkers, factors which can influence any comparisons between vegetarians and more red-blooded Americans.
Since the 1950s, scientists at Loma Linda University have been conducting numerous health studies on Adventists. The most recent have been trying to identify the health habits of the long-livers. I am here to meet Dr Gary Fraser, who's been leading this research for three decades covering over 150,000 Adventists. These huge epidemiological studies track people's diets and lifestyles and look for associations between what they eat, their overall health and what eventually kills them.
Hello.
Hi.
Hi, Mike Mosley, hello. Nice to meet you.
I'm joining the good doctor for lunch and as I'm on a high-meat diet, our choices couldn't be more different.
OK, so differences in what we've got here, then.
I've got pulled pork while Dr Fraser has a vegetarian salad with nuts.
I have to confess, I had bacon for breakfast as well.
OK.
I had four rashers of bacon.
Wow! All right. I hope you survive this experiment.
Thank you!
So kind of broadly, what have your studies revealed?
That when you look at cardiovascular risk factors in a broad sense - diabetes, hypertension, being overweight, having increased blood lipid levels - that the vegetarians are doing better than the non-vegetarians. And indeed that has translated in most of the studies to the vegetarians having a lower risk of heart attack and cardiovascular disease, so that whole area, I think, is fairly well established.
Dr Fraser found that men in the study who ate beef at least three times a week had double the risk of fatal heart disease compared to the vegetarians. And this apparently massive risk to health was in people eating under 60 grams a day, which is less than your average Brit and half what I'm currently eating.
So you have found that even eating what some people would regard as quite a modest level of meat makes a difference.
Yes.
I mean, how big a difference?
You know, I don't think we have all of the answers on that to be very precise about it and of course your plate of food there has got some things on there that go beyond the meat that I wouldn't necessarily recommend. So let me put it this way. That plate as compared to this plate, where I have replaced the meat with nuts and with whole-grain bread and so forth, our evidence says that you're probably looking at a difference of five years, four to five years in life expectancy.

Key:
1 half 
2 Adventist meat-eaters tend not to smoke or drink
3 150,000
4 the former is a meat-eater and the latter is a vegetarian
5 diabetes, hypertension, being overweight, having increased blood lipid levels
6 eat beef three times a week / 60 grams a day
7 four/five years

Shock of anorexia in later life

New research by the BBC's Breakfast programme shows a rise in the number of people in England and Wales who are middle-aged or elderly and struggling with eating disorders.

Self-study activity:
Watch the video and answer the questions below.



1 How old was the first lady when she was diagnosed?
2 What is the accepted wisdom about eating disorders?
3 By how much has increased the number of people in their 60’s receiving specialist outpatient treatment?
4 Ideally, when should treatment be given?
5 What did Chris lose in four years?
6 Who are the beneficiaries of the government's investments in this area?
 

I was 44 years old and it was a massive shock … massive.
What am I going to eat? When am I going to eat. What plate am I going to eat of? You know; is that too much? Is that too little; it dominates your life very much.
You didn’t believe that this could be happening to somebody with your age?
I believed it doesn’t happen to older people and it definitely didn’t happen to me.
The accepted wisdom is that eating disorders strike the young, but Julie and Chris are two of a growing number of older people with anorexia.
For me being that age when I was diagnosed, I really felt that I should have known better.
While the overall rate of eating disorders is thought to be in decline, research carried out by Breakfast, show that in older age groups it is significantly increasing. The number of people in their 60’s receiving specialist outpatient treatment increased by almost a quarter in the last 4 years. For those in their 50’s there was a sharper increase of almost a third. Last year one in every 6 who received specialist treatment was over 40. Why might this be? In some cases like Chris, it is patients who slipped through the net over previous decades.
If you don’t get treatment early on, then recovery becomes difficult. You end up going back to hospital again and again and again.
But experts we’ve spoken to believe that in many cases like Julie’s the illness struck late in life out of the blue.
I knew I wasn’t eating, I knew I was depressed, but I had no idea that I couldn’t physically eat. In the 4 years, I lost two thirds of my body weight. I lost my husband and my job and I almost lost my life.
We showed our findings of Age UK who said eating disorders for older people are a serious issue and often overlooked by health professionals. There is a need for better awareness and support in treatment which is largely focussed on the young.
If there were people of a similar age that I’ve got a connection with, I would acknowledge that this does happen to people like me; its not just young people who suffer.
The government is investing in the area, but only to improve services for the young. In a statement they say: “We are investing £150 million to develop services for children and young people and have set targets for their care. There are also plans to develop standards that will improve care for adults with eating disorders”.
The last time I was in hospital, it really brought me face to face with what I’d lost. To anybody who is funding treatment or anything like that I’d say, give those people a chance, give them the treatment now, because it can stop.

Key:
1 44 
2 that they strike the young 
3 By almost a quarter
4 Early on
5 Two thirds of body weight, her husband, her job and almost her life
6 The young